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ADENOID SIZE IN CHILDREN WITH OTITIS MEDIA WITH EFFUSION
Marta Zrinka Galić1, Marisa Klančnik1
1Department of Otorhinolaryngology, Split University Hospital Centre, Split, Croatia.
Insights
Enlarged adenoids (adenoid hypertrophy) significantly correlate with persistent otitis media with effusion (OME) in children. Higher grades of adenoid hypertrophy indicate a greater likelihood of treatment failure for OME.
Area of Science:
- Pediatric Otolaryngology
- Auditory Health
- Pediatric Respiratory Health
Background:
- Otitis media with effusion (OME) is a leading cause of pediatric hearing loss.
- Adenoid hypertrophy (AH) is a recognized contributing factor to OME.
- Understanding the relationship between AH size and OME persistence is crucial for standardized diagnosis and treatment.
Purpose of the Study:
- To investigate the correlation between the relative size of adenoid hypertrophy (AH) and the incidence of persistent otitis media with effusion (OME) in children.
- To evaluate the impact of AH severity on the failure of conservative OME treatment.
Main Methods:
- Retrospective study of 65 children (aged 2-12 years) with chronic OME and AH symptoms.
- Data collection included patient history, physical examinations, tympanometry, audiometry, and flexible nasal fiberoptic endoscopy.
- Adenoid grading utilized the Cassano method.
Main Results:
- No significant gender or age differences were observed.
- Highest OME incidence occurred in younger age groups (2-5 and 6-9 years).
- Grades II (35.38%) and III (50.77%) were the most frequent AH grades, showing statistical significance.
- Hearing impairment, snoring, and nasal obstruction were the most common symptoms.
Conclusions:
- Higher grades of adenoid hypertrophy are significantly associated with persistent OME.
- Severe AH may predict the failure of conservative management for OME.
- Findings support a standardized approach to diagnosing and treating OME in relation to AH severity.
Abstract:
Otitis media with effusion (OME) is amongst the most common pediatric diseases and the most common cause of hearing loss in children. It is accepted that adenoid hypertrophy (AH) is related to OME incidence. Better understanding of the correlation between the relative size of AH and the incidence of persistent OME may provide evidence to support a more standardized approach to the diagnosis and treatment of OME. A retrospective study carried out between April 2016 and April 2018 collected data on 65 children aged 2-12 years, diagnosed with chronic OME and symptoms of AH, where conservative therapy failed. Pre-diagnostic data were collected from patient history, otoscopy, rhinoscopy, and oropharyngoscopy findings. Diagnostic workup included tympanometry, audiometry, and flexible nasal fiberoptic endoscopy. Adenoid grading was performed according to Cassano method after endoscopic visualization. Of the 65 patients, 37 were male and 28 were female. There was no statistically significant difference according to gender or average age. The highest incidence of persistent OME with AH was recorded in the youngest age groups (2-5 and 6-9 years). The most frequent AH grades were grade II (35.38%) and grade III (50.77%), yielding a statistically significant result. The most common presenting symptoms were hearing impairment, snoring, and nasal obstruction (100%, 64.62% and 60%, respectively). Higher AH grades are critical for persistence of OME and may cause conservative therapy failure.
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